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September 13, 1995

Doxorubicin Followed by Cyclophosphamide, Methotrexate, and Fluorouracil for Breast Cancer-Reply

Author Affiliations

Istituto Nazionale Tumori Milan, Italy

JAMA. 1995;274(10):796-797. doi:10.1001/jama.1995.03530100036023

In Reply.  —The Table summarizes the comparative adjuvant results reported by the research groups1-3 quoted in the letter from Dr Michaelson. Although we concur in stating the limits of interseries comparisons, particularly when treatment results are at different follow-up periods, available findings reiterate the efficacy of our sequential drug regimen. We believe that doxorubicin followed by CMF represents a step forward in the control of occult micrometastases at the expense of minimal important toxicity. However, for clinicians who consider that in any clinical situation only results from prospective trials comparing newer vs older treatments commit them to apply an innovative therapy, we do not exclude the possibility that in the future some cooperative groups will offer the final verdict.